TY - JOUR
T1 - Plant Protein Intake is Associated With Fibroblast Growth Factor 23 and Serum Bicarbonate Levels in Patients With Chronic Kidney Disease
T2 - The Chronic Renal Insufficiency Cohort Study
AU - Scialla, Julia J.
AU - Appel, Lawrence J.
AU - Wolf, Myles
AU - Yang, Wei
AU - Zhang, Xiaoming
AU - Sozio, Stephen M.
AU - Miller, Edgar R.
AU - Bazzano, Lydia A.
AU - Cuevas, Magdalena
AU - Glenn, Melanie J.
AU - Lustigova, Eva
AU - Kallem, Radhakrishna R.
AU - Porter, Anna C.
AU - Townsend, Raymond R.
AU - Weir, Matthew R.
AU - Anderson, Cheryl A.M.
N1 - Funding Information:
We would like to acknowledge the time and commitment of the participants, investigators, and staff of the CRIC study. The CRIC Study is supported by cooperative agreement project grants 5U01DK060990, 5U01DK060984, 5U01DK06102, 5U01DK061021, 5U01DK061028, 5U01DK60980, 5U01DK060963, and 5U01DK060902 from the National Institute of Diabetes and Digestive and Kidney Diseases and by grants UL1RR024134, UL1RR025005, M01RR16500, UL1RR024989, M01RR000042, UL1RR024986, UL1RR029879, RR05096, and UL1RR024131 from the National Institutes of Health .
Funding Information:
J.J.S. was supported by National Institute of Diabetes and Digestive and Kidney Diseases grant 5KL2RR025006 from the National Center for Research Resources , a component of the NIH and NIH Roadmap for Medical Research, as well as the National Kidney Foundation of Maryland. C.A.M.A. was supported by K01 HL092595-02 from the National Heart Lung and Blood Institute .
PY - 2012/7
Y1 - 2012/7
N2 - Background: Protein from plant, as opposed to animal, sources may be preferred in chronic kidney disease (CKD) because of the lower bioavailability of phosphate and lower nonvolatile acid load. Study Design: Observational cross-sectional study. Setting and Participants: A total of 2,938 participants with CKD and information on their dietary intake at the baseline visit in the Chronic Renal Insufficiency Cohort Study. Predictors: Percentage of total protein intake from plant sources (percent plant protein) was determined by scoring individual food items using the National Cancer Institute Diet History Questionnaire (DHQ). Outcomes: Metabolic parameters, including serum phosphate, bicarbonate (HCO3), potassium, and albumin, plasma fibroblast growth factor 23 (FGF-23), and parathyroid hormone (PTH), and hemoglobin levels. Measurements: We modeled the association between percent plant protein and metabolic parameters using linear regression. Models were adjusted for age, sex, race, diabetes status, body mass index, estimated glomerular filtration rate, income, smoking status, total energy intake, total protein intake, 24-hour urinary sodium concentration, use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, and use of diuretics. Results: Higher percent plant protein was associated with lower FGF-23 (P = .05) and higher HCO3 (P = .01) levels, but not with serum phosphate or parathyroid hormone concentrations (P = .9 and P = .5, respectively). Higher percent plant protein was not associated with higher serum potassium (P = .2), lower serum albumin (P = .2), or lower hemoglobin (P = .3) levels. The associations of percent plant protein with FGF-23 and HCO3 levels did not differ by diabetes status, sex, race, CKD stage (2/3 vs. 4/5), or total protein intake (≤0.8 g/kg/day vs. >0.8 g/kg/day; P-interaction >.10 for each). Limitations: This is a cross-sectional study; determination of percent plant protein using the Diet History Questionnaire has not been validated. Conclusions: Consumption of a higher percentage of protein from plant sources may lower FGF-23 and raise HCO3 levels in patients with CKD.
AB - Background: Protein from plant, as opposed to animal, sources may be preferred in chronic kidney disease (CKD) because of the lower bioavailability of phosphate and lower nonvolatile acid load. Study Design: Observational cross-sectional study. Setting and Participants: A total of 2,938 participants with CKD and information on their dietary intake at the baseline visit in the Chronic Renal Insufficiency Cohort Study. Predictors: Percentage of total protein intake from plant sources (percent plant protein) was determined by scoring individual food items using the National Cancer Institute Diet History Questionnaire (DHQ). Outcomes: Metabolic parameters, including serum phosphate, bicarbonate (HCO3), potassium, and albumin, plasma fibroblast growth factor 23 (FGF-23), and parathyroid hormone (PTH), and hemoglobin levels. Measurements: We modeled the association between percent plant protein and metabolic parameters using linear regression. Models were adjusted for age, sex, race, diabetes status, body mass index, estimated glomerular filtration rate, income, smoking status, total energy intake, total protein intake, 24-hour urinary sodium concentration, use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, and use of diuretics. Results: Higher percent plant protein was associated with lower FGF-23 (P = .05) and higher HCO3 (P = .01) levels, but not with serum phosphate or parathyroid hormone concentrations (P = .9 and P = .5, respectively). Higher percent plant protein was not associated with higher serum potassium (P = .2), lower serum albumin (P = .2), or lower hemoglobin (P = .3) levels. The associations of percent plant protein with FGF-23 and HCO3 levels did not differ by diabetes status, sex, race, CKD stage (2/3 vs. 4/5), or total protein intake (≤0.8 g/kg/day vs. >0.8 g/kg/day; P-interaction >.10 for each). Limitations: This is a cross-sectional study; determination of percent plant protein using the Diet History Questionnaire has not been validated. Conclusions: Consumption of a higher percentage of protein from plant sources may lower FGF-23 and raise HCO3 levels in patients with CKD.
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U2 - 10.1053/j.jrn.2012.01.026
DO - 10.1053/j.jrn.2012.01.026
M3 - Article
C2 - 22480598
AN - SCOPUS:84862692740
SN - 1051-2276
VL - 22
SP - 379-388.e1
JO - Journal of Renal Nutrition
JF - Journal of Renal Nutrition
IS - 4
ER -